St. Joseph's hospital restricts Obamacare patients to one insurance carrier

by Jim Kenyon

Mon, 10 Mar 2014 19:18:18 GMT —

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Oswego County man says he's on the hook for nearly $1,800 because St. Joseph's hospital only deals with one insurance carrier when it comes to patients under Obamacare.

Donald Webb, who is disabled and lives near Mexico NY. says he went through the New York Health Exchange last year to sign up with MVP Health Insurance. In January, he underwent two procedures to treat wounds on his leg at St. Joseph's Hospital Northeast Medical Center in Fayetteville. Webb says he showed the staff at the center his MVP insurance card. "they said, MVP? You're good to go, no problem."

It wasn't until recently that Webb found out there was a problem. He did not know that on December 20th, St. Joseph's Hospital Health Center sent a letter to area health care providers informing them that it would only honor Excellus as the insurance carrier for patients under New York State's Health Insurance Exchange. The hospital would be "out of network" for Obamacare patients insured by other companies such as Fidelis, MVP, American Progressive and Health Republic.

Webb says he's being billed for nearly $1,800 because St. Joseph's won't take his insurance through MVP. "I'm on a fixed income. I don't have the ability to pay this bill or the ones that are going to come." Webb says he has cancelled future medical appointments with the hospital and will search for alternatives.

Kerri Howell, a spokesperson for St. Joseph's Hospital says it decided to "participate with the Excellus exchange, because we want to go with insurance we're familiar with." A quyestion and answer attachment to the December 20th letter states: "Some plans (Fidelis and MVP) have opted to create narrow provider networks for their Exchange enrollees. This means that they are limiting the choice of providers that their members and your patients can be referred to."

The attachment underlines the following: " To reiterate, St. Joseph's will continue to be "in network" for Fidelis and MVP products that are not sold on the Health Insurance Exchange."